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. <br /> _ ,y'.-..: .. - . . _ . . . . . , . <br /> .� . � . � . . . . � . .. . � . . . � - . . . <br /> ` �� ��� � ���'�'�PERIv1IT'FE C �` <br /> , 5�-� a ���� �. , E��.E�L`CT�L���ION{S) ��`n �;�����..��'� ;�� { �; <br /> .€t s . 3� t:- _ s-� -� '-ti s t e � x <br /> - _ BASED'�O�'F �2002;5'I`ATES`FATU��� ` ��:���{� ��r�=i��� �f� ���� <br /> , ,. . . . : <br /> r �..: <br /> _ ❑ .Yes,this section applies � <br /> _ The replacement of a Residential fixture or appliance that meets all three of the following requirements: <br /> t� 1. Does not require modificarion to electrical or gas service. <br /> 2. Has a total cost of$500.00 or less;excludin�the cost of the fixture or appliance: and <br /> �.' 3. Is unproved,installed or replaced by the homeowner or licensed contractor. <br /> _ � ;�� , Skip next section,if this applies; : Cost of Pernut $ 15.00 <br /> � � �� Sfate Surcharge � � $. ���� .50- <br /> - Mail-In Fee(If Applicable)� $ ' 1:50 . � <br /> . Total Permit Fee $ : _ <br /> '��� ` � �:� PERIVII'�'�.FEE CAL,�T�L�A'�ION�(�) f�JO�S"OVEB$SOC�'00�..�� .�-� �; � ,�: <br /> ;���,._ ' ,,> � � �.� �,�, <br /> If above does not apply; follow guidelines below: <br /> � 1. CONTRACT PRICE *is 1.25%of contract price with a(Minimum Fee of$35.00) <br /> ' -'^ ..:;.. <br /> � . :. <br /> ���C7 x.0125 $ ��•� <br /> `; ` '' (conhact price) • (minimum$35.00) ,.'. ' � <br /> 2. STATE SURCHARGE **Add the State Bldg Code Div. Surcharge (Minimum Fee of$.50) <br /> x .0005 $ . � <br /> (contract price) (minimum$ .50) <br /> 3. POSTAGE&HANDLING(Only on Mail-In Applications) $ �}.5�`. <br /> _ 4. TOTAL PERMIT FEE(Add Lines i-3 Above) $ �:�'� <br /> ' `' * CONTRACT PRICE or 70B COST means the actual or esrimated dollar amount charged for the <br /> pemutted work including matenals, labor,profit, and other fixed costs. It is the amount to be charged <br /> to the customer for the work done. If any material, equipment, labor or installations are furnished by � <br /> the owner, tenant or any other party, the reasonable market value of such items must be added to the <br /> estimated cost or contract price for pernut fee puiposes. In the evenf that there is a dispute on the <br /> amount of the job cost, the City may request the submission of a signed copy of the actual contract: <br /> � • **The STATE SURCHARGE is.0005 of the Building Departrnent at(952) 249-4600 for the price. <br /> �:° r; MEGHANICAL:PERMIT APPLZCATIO�I:�IGREEMEI�T��������`,��',���„��: . . <br /> The undersigned hereby applies to the City for issuance of a Mechanical Pernut, agrees to do all <br /> work in strict accordance with the ordinances of the City and the regulations of the State of <br /> Minnesota, and certifies that all statements made on this application are complete, true and <br /> correct. <br /> � <br /> Applicant's Signature: Date: ��� L � � � <br /> 3 <br />